Ideal Cardiovascular Health Predicts Lower Risks of Myocardial Infarction, Stroke, and Vascular Death Across Whites, Blacks, and Hispanics: The Northern Manhattan Study
Open accessAbstract
Background—: Evidence of the relationship of cardiovascular health (CVH), defined by the American Heart Association, and specific cardiovascular outcomes is lacking, particularly among Hispanics. This study sought to evaluate the relationship between the number of ideal CVH metrics and cardiovascular risk, overall and by event subtype, in a multiethnic community-based prospective cohort. Methods and Results—: A total of 2981 subjects (mean age, 69±10 years; 54% Caribbean Hispanic, 25% black, 21% white) free of myocardial infarction and stroke at baseline in the Northern Manhattan Study were prospectively followed up (median follow-up, 11 years). The relationship between the number of ideal CVH metrics and the risk of cardiovascular disease, including myocardial infarction, stroke, and vascular death, was investigated. Overall, a strong gradient relationship was observed between the adjusted hazard ratios for cardiovascular disease and the number of ideal CVH metrics: 0.73 (95% confidence interval, 0.60–0.89), 0.61 (95% confidence interval, 0.50–0.76), 0.49 (95% confidence interval, 0.38–0.63), and 0.41 (95% confidence interval, 0.26–0.63) for those having 2, 3, 4, and 5 to 6 ideal CVH metrics, respectively, compared with those having 0 to 1 ideal CVH metrics ( P for trend <0.0001). Similar graded relationships were found between the number of ideal CVH metrics and the adjusted incidence rate for each specific outcome and among whites, blacks, and Caribbean Hispanics. Conclusions—: Our findings demonstrated a steep gradient relationship between ideal CVH and individual cardiovascular disease end points, including stroke, that was similar for whites, blacks, and Caribbean Hispanics. This evidence supports the application of the AHA ideal cardiovascular health metrics for cardiovascular disease risk assessment and health promotion for all Americans regardless of race-ethnic background.
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Data from 2002-2004 suggest that approximately 1 in 5 nonsmokers 12-17 years of age are likely to start smoking.
“Data from 2002 to 2004 suggest that ≈1 in 5 nonsmokers 12 to 17 years of age is likely to start smoking.”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
There was no significant difference in susceptibility to start smoking between boys and girls in any of the major populations or subpopulations.
“There was no significant difference in susceptibility to start smoking between boys and girls in any of the major populations or subpopulations (NSDUH).11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
Youths in Mexican subpopulations were significantly more susceptible (28.8%) to start smoking than those in non-Hispanic white (20.8%), non-Hispanic black (23.0%), Cuban (16.4%), Asian Indian (15.4%), Chinese (15.3%), and Vietnamese (13.8%) subpopulations.
“Youths in the Mexican subpopulations were significantly more susceptible (28.8%) to start smoking than those in non-Hispanic white (20.8%), non-Hispanic black (23.0%), Cuban (16.4%), Asian Indian (15.4%), Chinese (15.3%), and Vietnamese (13.8%) subpopulations.”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
No state met the Healthy People 2010 goal of reducing obesity to 15% of adults.
“Additionally, no state met the Healthy People 2010 goal of reducing obesity to 15% of adults.11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
NHANES data showed that treatment of high LDL cholesterol increased from 28.4% of individuals during 1999-2002 to 48.1% during 2005-2008.
“NHANES data on the treatment of high LDL cholesterol showed an increase from 28.4% of individuals during 1999 to 2002 to 48.1% during 2005 to 2008.11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
Genetic markers have not been shown to improve prediction of subclinical atherosclerosis beyond traditional risk factors.
“Genetic markers have also not been shown to improve prediction of subclinical atherosclerosis beyond traditional risk factors.11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
Analysis of NHANES/NCHS data from 1988-1994 to 2005-2006 in adults aged 20 years or older showed that 40% of those with diabetes did not know they had it.
“Analysis of NHANES/NCHS data from 1988–1994 to 2005–2006 in adults ≥20 years of age showed that 40% of those with DM did not know they had it.11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
In 1999 to 2002, among overweight or obese adolescents, 44% had metabolic syndrome.
“In 1999 to 2002, among overweight or obese adolescents, 44% had metabolic syndrome.11”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
CKD prevalence was a bit higher in Mexican Americans (18.7%) and non-Hispanic blacks (19.9%) compared with non-Hispanic whites (16.1%).
“The prevalence of CKD was slightly higher among Mexican Americans (18.7%) and non-Hispanic blacks (19.9%) than among non-Hispanic whites (16.1%).”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [11]
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References 36 · Cited by 338
- Authors
- Dong, C., Rundek, T., Wright, C. B., Anwar, Z., Elkind, M. S. V., & Sacco, R. L.
- Affiliations
- University of Miami (US)
- Venue
- Circulation
- Published
- 2012-06-19
- Volume
- 125
- Issue
- 24
- Pages
- 2975-2984
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3396556
- OpenAlex
- W1968944905
- Cited by
- 338
- References
- 36
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 23 · 2023: 28 · 2022: 22 · 2021: 22 · 2020: 29 · 2019: 18 · 2018: 27 · 2017: 31 · 2016: 43 · 2015: 36 · 2014: 24 · 2013: 19 · 2012: 3
- FWCI
- 16.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R37NS029993, R37 NS 29993.)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- ideal cardiovascular health, cardiovascular risk, myocardial infarction, stroke, vascular death, race and ethnicity, Caribbean Hispanics, African Americans, cardiovascular risk assessment, Northern Manhattan Study, health promotion
- MeSH terms
- Aged, Cardiovascular Diseases, Female, Health Promotion, Hispanic or Latino, Humans, Longitudinal Studies, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Cohort Studies, Risk Assessment, Stroke, Black People, White People
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